Electrodiagnosis-directed treatment of cervical radiculopathy

H-REFLEX HAS BEEN USED to identify a spinal posture that decompresses the impinged spinal root in patients with radiculopathy. This posture, optimum spinal posture (OSP), is prescribed as a therapeutic exercise to relieve radicular pain in patients with radiculopathy. The purpose of this study was to examine the effect of the OSP, as identified by flexor carpi radialis (FCR) H-reflex latency on functional ability in patients with cervical radiculopathy. Sixteen patients aged 41 +/- 9 years with confirmed cervical seven (C7) radiculopathy for at least the past 6 months participated. The H-reflex was elicited by electrical stimulation of the median nerve at the cubital fossa and recorded from the FCR muscle. Four traces of the H-reflex were recorded and averaged in the natural head position and in the OSP. The functional ability was evaluated using the neck disability index (NDI) before exercising in the OSP and after 2 days of exercising 15 minutes three times a day in the OSP. The H-reflex latencies in the OSP were significantly lower than latencies in the natural head position (p<.005). The NDI scores were considerably improved after exercising in the OSP (p<.005). Spearman's correlation coefficient showed a strong association between the H-reflex latency in natural head position and functional ability before exercise (r=.74; p<.015) but not between H-reflex latency in the OSP and functional ability after 2 days of exercising 15 minutes three times a day in the OSP (r=.24). It seems that the OSP decreased the H-reflex latency of the compromised cervical root and improved functional ability in this group of patients.